>> this coming tuesday will be a crucial time here in massachusetts. voters will go to the polls and select a person who may well determine the outcome of a long fight over health care

legislation in washington. at stake it well is jobs, energy, the environment, abortion, the war's oversea. we have much to talk about. moreover, the candidates are seeking to fill a seat that is legendary in american politics. among the giants of the past, ted kennedy and his brother john, to henry cabot lodge, charge sumner, daniel webster, and john quincy adams. those are some shoes to fill. this debate is sponsored by the edward m. kennedy institute for the united states senate. where it gathered at the boston campus of the university of massachusetts, on whose land the kennedy institute will eventually be built. in an order determined by lottery, let me introduce the three candidates that are with us. scott brown, the republican

candidate, is in his third term in the state senate welcoming -- representing the north folk district. martha coakley, the democratic candidate, was elected in 2006 after serving eight years as district attorney of middlesex county. joseph kennedy, no relation to the late senator, is an independent candidate who was a member of the national libertarian party pretty worse in information technology. in preparing questions, i consulted with members of the media and other peoples whose judgment i trust. the questions themselves are known only to me. to the audience, once again, hold your applause until the end. we will begin with a series of question to the candidate, leaving time for response in discussion. by lottery, the first question

will go to mr. brown, and then as quickly -- ms coakley, and then mr. kennedy. let us begin. president obama and members in congress are now in final -- the final stage of having out a national health-care bill. there is a real possibility that the winner of this election will be in a position to ensure passage of the bill for its defeat. do you want voters in massachusetts to see next tuesday's vote on a referendum on this national health care bill? mr. brown? >> thank you and a pleasure to be here. i think the institute. i thank you for your question. the health care bill being proposed in washington is broken by the bad deal -- by the back room deals. we need to start over. we have health care here in

massachusetts. 98% of our people are already insured. we have done it. we do not need what is being pushed in washington on massachusetts, spending $500 million on medicare? we know we need to reform and that is something we're going to be doing very shortly. to think that we need of one size fits all plan from congress, coming down here and hurting what we have? that is one of the differences between martha coakley and i. at a time when we just do not needed. i would propose going and allowing states to do this individually with the government incentivizing it. we can export what we have done and show them how to do it. i am looking forward to be the party -- the 41st vote and get that plan back to the drawing board. >> thank you for hosting us here this evening. i would be proud to be the 60th

vote to make sure that we need health care reform that was so badly need. we have taken the lead here in massachusetts, and now we are attacking the cost to provide competition and transparency to bring the costs down. we spent $2.60 trillion on health care in this country. we do not get our money. we do not have transparent terry -- transparency in competition. we do not have the kind of health care that we need. senator kennedy said that it is the right and not a privilege. by doing it incrementally is the way that we're going to do it, and we will set the groundwork for the revolutionary way in which we provide coverage for those it cannot get coverage now, making sure that we keep costs down so that people can keep the health care that they have now. >> mr. kennedy. >> the health care bill is a

travesty. as much as i would like to think that there's a 41st vote against that, the reality is that we're seeing of votes bought. every time is gone through, we have seen another person failed because they had been bought. issue is not who is going to vote down health care. it will be bought because of the politics as usual going on in washington did the question is, who is going to work to repeal it once it passes? we have an issue in government that it is too big. this bill will cost $1.20 trillion, so it is planning what that number means. our federal income tax is only $1.10 trillion. that means an 11% increase on everyone at minimum to pay for this bill. we cannot afford it, we should not do it. health care in massachusetts is

going up rapidly and it will let the federal level as well. >> mr. brown. >> we have this in massachusetts. that is why people actually come here. not only is this bill going to be bad for our state, my job as the center of massachusetts is not going to be subsidizing. we will be subsidizing what other states have failed to do. .

>> we've taken great care to ensure we have fantastic plants here from the so-called plans that union members are getting, businesses,, -- down to the [unintelligible] we should not have to go to washington every time to get handouts. we should be able to fix the problems on our own and we can do that easily. >> can you promised the voters if you are elected you are a going to vote regardless of how it is changed? >> what i have said is i support the plan coming out of the senate. >> water becomes more restrictive? >> i would not vote for a plan that had stupak on it.

>> you will only vote for the senate bill. >> it is not going to be a senate bill. the bill is going to be a compromise. regardless of what version comes out, this bill is not good for massachusetts. it will cost us jobs ant a time we cannot afford it. >> you said you are for health care reform, just not this bill. we know from the clinton experience that if this bill fails, it could be another 15 years before we see a health care reform effort began in washington. are you willing under those circumstances to say i'm going to be the person, i will sit by and teddy kennedy's see? >> it is not the kennedy seat or the democratic seat. they have a chance to send someone who is an independent voter and thinker and look out for the best interests of the

people of massachusetts. i would like to send them back to that drawing board. people should have insurance. it is not good for the entire country. we're talking about an additional zero trillion dollars in costs and half a trillion -- if your a veteran you are having cuts in tricare. no one has confidence in this bill now. >> this morning the head of the afl-cio said that it would be a recipe for disaster if the final health care bill includes a tax on high-end insurance plans. what is in the senate bill. senator obama says he is for that hat -- tax on plans. where do you come down? >> the president said he thought there was room to determine what is going to be in this plan

spread may be the broad -- the net could include a couple of toyotas. i do not agree with that and there are different ways we could pay for that plan. >> this is not about cars, it is about health care. the plans we're talking about here -- is going to be taxing those cadillac plans for those union members who have fought to get those plans. how are you going to pay for this? cutting half a trillion dollars out of medicare and you are going to be taxing people at a time they cannot afford it. we can do better. we can go back tohat states can rely on and have the flexibility. not a one-size-fits-all for the country and the hurting states. >> i am going to turn to you and

you can -- all of you have talked about the economy. voters put jobs at the top of their list. everyone is worried about 10% unemployment. it is also true that this terrible economic situation workers find themselves in comes at the end of a lost decade for american workers. there has been nationwide, no net job growth since december, 1999 and middle class families when adjusted for inflation have not seen their incomes rise. what are your plans not only short term but what is the answer to the long-term challenge for jobs for americans? >> if i can no to that the congressional budget office says within 10 years that health care plan will be deficit neutral. one of the reasons we have issues is because during the last decade we have not had regulations that have kept the economy in check. with predatory lending. with the bush-cheney tax policy

that supported the haves and have mores -- he wants to go back to the drawing board. he wants to go back to those bush dashed any policies that provide for the wealthy. i supported and i said i support a plan that will provide tax relief for that -- relief for the middle class. to provide for tax credits and more landing opportunities for small businesses which will be the engine that will get this economy moving again. >> these wages have not risen in america since 1972 so it is not just the last 10 years. we have lost 40 years. we need to get the economy going. the way we do that is cut spending. harding did it in the 1920's and we have not done it since. we continue to spend money on wars and on entitlement plans. these things draw money from the private sector into the public

sector and year after year, we see the public sector growing. we see people not getting real wage increases. that is what is going on. until people are willing to cut spending, cut entitlements and stop going to war around the world which is extremely expensive, we are not going to fix this economy. there is no way, shape, or form. we have a number of bureaucracies in government. we have wasteful spending of in government and nobody is holding them accountable. somebody needs to stop the war. somebody needs to pull back the entitlement programs and somebody needs to give the money back to the taxpayer. que>> congressional budget offie is going to take 10 years. we will be subsidizing other states for the next four or five years but we will break even. that sounds like a bargain. i would rather send it back to the drawing board. regarding tax cuts there is no

one who was listening [unintelligible] i have a history of cutting taxes, holding the line on spending. i've been fighting on beacon hill against the machine who wants to raise your taxes. gov. patrick and everybody else. we can do better. regarding your comments about bush-cheney this and that, you can run against bush-to any but i am scott brown. i drive a truck and it is over to a dozen miles on it. you are not running against them. you are running against me. the difference between us is you want to raise taxes. on items that you were vocal about during the primary. it is not $2.10 trillion what is the number you want to raise taxes? >> it does not matter how many times you say $2.10 trillion. it does not make it accurate. it is not a number because what

i support our relief for the middle class. the cuts that president obama support, health care plan that will be self supporting. your response to health care costs is to make sure that we let insurance companies [unintelligible] sot hat is not a good way to go. we have an energy policy that will make polluters pay. those numbers -- we are down to zero. your the one who bought it while you were in the senate for over $7 billion of spending in the commonwealth. you voted for $300 million of fees so let's get that rhetoric straight. i am not [unintelligible] i brought back $1 billion back to the commonwealth as attorney general. >> i have never voted for a tax increase while elected in office.

the items you're talking about -- it is outrageous that you would say i would not be supportive of women's rights and protecting mammogram covered. that is the basic coverage in our health plans. when we@@@ let's be clear on the facts.

you cannot distort my record and i will be accurate about yours. i have not proposed any new taxes except for those on the wealthiest 2% of the country. that is all i have ever talked about. let's be clear. what i propose is going forward to make sure we cannot afford for health care. it is 8% to 10% a year going up. >> you are in favor of cap and trade. >> it is not a tax. >> our favorin -- you are in favor of the tax cuts coming back. the tax credits are coming back. i am sorry. >> i hear you talkinhg about tax cuts to create jobs.

the importance of that. there is the second issue. that is the deficits. the truth of the matter is over the horizon are these massive deficits. we have 1.4 trillion dollars now but every year, the amount is one trillion dollar -- $1 trillion more. >> the answer here is i have been saying. nobody to my right has been willing to talk about spending cuts and everyone who says -- >> what would you cut? >> i do not think we have enough time. i will cut obamacare when it passes. i will cut every single hack job that is out there that exists today. i will audit the federal reserve and i will see to it that there is -- if there is corruption there we will cut that as well. i will stop spending money on

the wars. we have people in japan and in germany to defend wealthy nations today. you know who pays for? we pay for. everyone is incorrect when they say that cutting taxes creates jobs. that is not the truth. cutting spending historically is what creates jobs. when you cut taxes and you do not cut spending, we get what we had in the bush administration is -- which is what it bankrupted our country. >> we need to do it jfk style across the board. for businesses and families that will create jobs. we have done a stimulus 1. we're looking at stimulus two. when it be nice to try something different? the stimulus bill has not been working and it has not created one job. we're 49 at a 50 in releasing the money we have. how can we talk about other --

about another stimulus bill when the other has not worked. the spec -- get back to basics. [unintelligible] it is important to do that. that is the difference. her tax proposals will not help but all. it will add to the deficit. the cap and trade scheme will increase taxes. that is the major differences. >> i think the question was about the deficit. let's remember the history here. when the democrats had the presidency we were at a pay-as- you-go. that went out the door with the bush-cheney deposition. -- bush-cheney administration.

to me it is astounding that scott brown will stand here and say that this problem must have come out of nowhere. his solution is to do nothing except to make sure that we do some kind of across-the-board tax cut. it is not going to work and what i have said in what he knows i have said is we need to get tax revenues that. we need to get the engine of this economy running again. >> how would you get tax revenues that? >> getting people back to work. >> president obama has made the vow no tax increases. the a join him in that pledge? >> i do. >> you think you can balance the budget? >> not overnight. it was greeted by reckless administration. we have a lot of work to do.

those are complicated problems. >> the tax cuts we're talking about will create an immediate jolt to the economy and create jobs. to think that it is all about bush-cheney, there is plenty of blame to go around. i am looking to address the mistakes of today. there are clear differences between the to a bus on those issues and if you think a tax cut is not going to work that i think you are sadly mistaken. >> we have gone through tax cuts in the bush years and we did not have this booming growth which you have assumed and the congress has -- people have been afraid to take on the entitlement programs. i want to know if you are taking on the entitlement programs or

are we going to duck and see these costs go through the roof? >> i am the only one who has talked about spending. spending is something that is difficult to cut. it is difficult to say, we have to cut entitlement programs. there is a lot of fat. no one wants to talk about cutting spending is because they cost votes. every single time you got there and say i will cut your taxes and raise retirement program, you're lying to get votes. we have to cut spending. >> medicare, medicaid, and social security. where would you cut them? >> i am ready to take on the entitlement programs. >> senator gregg has filed a bill. you look at the entitlements and you have a bipartisan commission that will look at everything and make a recommendation. i look forward to that opportunity.

>> would you support tax increases? >> i think we can do better. i would certainly look at entitlements and make that recommendation. at least we have the choice and that is what is important. >> we spent a lot of taxpayer dollars on bailing out big corporations, millions and billions of dollars on stimulus money. taxpayer dollars that did not have to be spent if we had done better regulation. i will not say we're going to take away social security from our greatest generation, with folks with whom we have a contract. there have to be ways that we reach our obligation on that. i think we have to start with where the blame falls and where we turn this around. >> bottom line? what is your position on whether the congress ought to consider and be open to reforming social

security, medicaid, and medicare in a way that brings down the costs on all three programs. >> i believe that everything can be looked at but i will say this. i think that if we look at new generations coming in who do not have this entitlement, this is not the first case i will look. >> is it a place where you are willing to look because that is where the money is. >> there is a good reason for that. this is about more than the budget. people depend upon that for health care. >> it is not about blame. it is about solving the problems of today. we have to do a top to bottom review to make sure as the president called for. we can do it in washington. we need to forget about blaming people. there is plenty to go round. let's solve the problems of today. you need to look at every other program and project in washington.

>> let's move on. i would love to work through these more deeply. the clock is working in another direction. i would like to go to a new question. the president declared we are in a war against al qaeda. how do we win the war? >> we're in a war. it has happened here. the attempt by the person who tried to kill our kids at the mall. i am glad he is realizing we are at war. he was slow in reacting to that situation. martha believes that these individuals should be given constitutional rights. attorneys -- a lawyer dubbed so they can take the fifth. they should be treated as enemy

combatants and they should be interrogated pursuant to laws of the land and make sure we find out if there is any of their attacks coming. that is a major difference. half a billion dollars it is going to cost. khalid sheikh mohammed is taking the fifth. he is getting information from us. martha agrees with that. he should be treated as an enemy combatant and go through ita military tribunal. the training i have, i am looking forward to that opportunity. >> there is nothing more important than keeping this country safe and keeping our homeland security save. we need to do it as smartly as we can. we have been at war since 9/11. i have worked as a district attorney and an attorney general everyday sense columbine, keeping our kids safe and working with federal and state authorities and local police,

fire, to make sure that 9/11 never happens again. that means that we have to be smarter and we have to work better to use better intelligence and analysis about where al qaeda is and how we will neutralize them. i am surprised at scott because he is a lawyer and he does defense worke and he understands what constitutional rights are about. we need to do whatever we can to keep our people say. as we move forward, we have to make sure that we have the right intelligence and move properly and when we should try people in military tribunals, do that as we can be successful. >> if we want to secure the people of america, we have to not say, where we're at war with al qaeda? we need to understand why is al qaeda at war with us?

we occupied nations in the middle east. if you are growing up and you have someone from a foreign nation walking up and down your streets with a machine gun, you're going to grow up hating the country. you are just going to trade when you turn 15 or 16 it will be easy to recruit you to come over and kill us. that is what is happening. the reality is if we want a safer country, we need to not occupy these lands. we need to take an pullback the individuals who are deployed today. we need to take the money that is used to pay for the deployment and use it internally to secure our borders. if we focused on securing america and did not go over there and interfere in their lives would have fewer enemies and we would be concentrating our forces where we need them. which is in america. >> thank you. i'm glad you recognize my service. i may lieutenant colonel with 30 years in the military.

i do not recall a time we have given constitutional rights to terrorists [unintelligible] to think that we would give people who want to kill us constitutional rights and lawyer them up at our expense instead of treating them as enemy combatants -- it makes no sense to me and shows me that you do not understand the law when it comes to enemy combatants versus terrace. >> the reason we started the designation is we would make sure we treated people appropriately. we still and always will have the option to get better intelligence to treat people in the military enemy combatant form. >> in a standard differences on the legal treatment of prisoners. what i would like to understand is how you would win the war on

the ground. >> i agree with the president. that is another difference. i support his effort to finish the job in afghanistan. @@@@ jrbrbfá >> and export them around the worm. -- world. it's pretty simple. you make sure we support our troops and support our president unlike martha in a time of war. we're at war at our airports. we're at war at our shopping malls. and i have to be honest with you, folks, as you're listening, i'm scared some of the policies i've heard in giving enemy combatants constitutional rights. i want to know when the next terror strike is going to happen and we're not going to find it by the policies you're pushing

number one and i support the president and i'm proud to do so. >> ms. coakley. >> just in response to that. we had almost 200 trials, civilian trials that have been successful in holding people accountable when they have been designated by the bush-cheney combatants in guantanamo. they made that decision presumably the attorney general can do that, too and will do that. i don't agree with president obama's decision to send troops to afghanistan. and so as a side note, you know, scott selectively picks and chooses what is apparently the right policy for the country. >> how do you think we then succeed in afghanistan? >> in afghanistan, i think we are going to do what we've been able to do in afghanistan. >> you think we should come home? >> i think we should plan an exit strategy, yes >> and how would we succeed? >> i'm not sure there is a way to succeed. if the goal was to go in, and if the terrorists harbored terrorists, i supported that

goal. they are not there. they are in apparently yemen and pakistan and let's focus our efforts in al-qaeda and not -- >> would you then send troops in yemen where al-qaeda is. >> no, that's exactly the point. this is not sending troops where al-qaeda may be where they're training. we have all kinds of resources at our disposal including cia. our allies who work with us and the focus should be in getting the appropriate information on individuals who are trained to represent a threat to us and use the force necessary to go after those individuals. >> excuse me. >> one brief intervention and we're going to move on. >> let me explain what the submission. the taliban will not move on forces, go to pakistan and get nuclear weapons and export them around the world, number one. and to think al-qaeda is not everywhere we're talking about and we should not be going in addressing these very real concerns i think is naive. we have some real problems. >> in fairness, ms. coakley, do you have a response to that. >> i think it's naive to think

that we have the troops to send everywhere and they are the best way to go after people who are terrorists, who disappear into the night, who do trainings and who get on planes frankly with bombs on their shoes and other pieces of clothing. >> excuse me, one second, then you're saying once we catch these people we're going to be giving them constitutional rights. >> that's not what i said, scott. we're talking about ground wars. >> you're talking about khalid sheikh shootings a lawyer. we should have taken the time and interrogated him properly to find out what's next? >> we apparently have information. neither you nor i know what this is. >> this is very constructive but we're going to change the format and we're going to allow each candidate, this is unusual, allow each candidate a chance to ask the other two candidates a question and get a minute-long response. we'll start with ms. coakley. she will have a chance to ask

mr. brown a question and mr. kennedy a question and somehow i think it may be a continuation of what they may be talking about. >> maybe not. scott, in massachusetts, you've supported legislation that would allow hospital employees to deny emergency care to rape victims if it was their choice. you have also in this campaign received the endorsement of the massachusetts right to life organization that said you will be a vote for right to life -- a vote for life in the senate. do you accept their endorsement or do you disavow that? >> well, first of all, thank you for your question. i have a very big tin. i appreciate everybody's support because this isn't about democrats, republicans and independents. it's about everybody. and i support everybody's support as you do as well. you have many special interests groups support. they are rallying around you to support the machine. yes, i did vote on a bill to allow women who are raped to get treatment. i supported. and i'm very proud of that vote and you and i both had the same position on abortion.

that's roe v. wade is the law of the land and yet we have really difference. you wrote an editorial that anyone can go online and find when you actually criticized partial birth abortion the fact that it's not allowed. and we also have a difference in that. i don't believe that federal funding of abortion should be allowed. and i believe in a very strong parental consent law. as somebody who's being supported by emily's list you will go down as a social crusader to file the bills as everybody else is supported by them is. i want to be a jobs crusader. i don't want to be a social crusader and i want to deal with the issues that are very important to us. and to think i would even especially with my two young daughters here to think i wouldn't allow them the opportunity if they were raped to have the immediate attention, i think, is abhorn. -- abhorrent. >> the time is up.

you should have an appropriate time to respond and then you have a chance to ask -- >> am i wrong, scott, that the bill you filed allows for emergency personnel to deny care if it's -- within their decision? >> yes, you're absolutely wrong. >> i'm right or wrong? >> you're wrong. >> i'm not in your courtroom and i'm not a defendant. so let me answer the question. the amendment that you're referring to allowed hospitals who had religious preferences not to perform abortions or provide those services. >> emergency contraception. >> once again i'm not a defendant. i would like to have a chance to answer commonwealth. -- question. that was an amendment filed by many people. the bill passed. i was proud to vote for it and would do it again. >> you think it's a correct position to take. i want to be clear. >> to allow women to get an emergency contraceptive if they'd been raped, yes. >> and they can be turned away

if it's up to an individual. >> it's abhorrent that would midwest the bill around. -- twist the bill around. >> given the time constraints we're going to move to one question. i'm going to ask mr. kennedy if he would pose a question to either one of the two candidates. >> okay. ms. coakley, very simple question for you. we have a healthcare bill in front of us that will cost $1.2 trillion. right now the total amount of money that is raised on a yearly basis by all circulars that come via the federal income tax is at $1.08 trillion. so this is over a 10-year period. are you willing to increase taxes on everyone 11% to pay for this healthcare bill because that's what it costs and it won't be able to be done by just taxing the wealthy? >> no, because i disagree with

the premises in your bill. everyone appreciates that healthcare needs reform and it's complicated and we can throw numbers around and argue about it. we did in massachusetts and we look at costs and as we go forward on the national level we can't afford not to do healthcare reform so we can figure out how we have to pay for it, what we will save by early prevention, early screenings, the ways in which we turn around, how we pay for these services. we pay far too much for the results that we get in healthcare. >> just to go on the record, the numbers i'm giving you are the numbers from the government and from the tax foundation. >> and the congressional budget office says in 10 years it will be deficit neutral, budget neutral. not just these dollars and cents on this side of the ledger who don't have insurance will get it. we'll see people who pay out of their pockets to get screenings that insurance companies won't pay for.

and then they need less invasive procedures. as a friend of mine found out. so the insurance company pays money on her. we can do it and get better results and save money. we're not going to do it overnight. i agree with that. >> mr. brown, you'll have a chance to ask one of the candidates a question. i can't guess what candidate it might be. >> i'll tell you, it'll be martha. >> we're both good people. that's the consensus on the trail. we have differences, many differences. i happen to think you're wrong on the policies. one of them is the issue on terror. you want to provide constitutional rights to enemy combatants and treat them like enemy criminals and i don't. a little bit of a difference. simple question, khalid sheikh mohammed has been -- he will be tried in new york. at taxpayer expense and you've supported that and you made that very public. if, in fact, he's found guilty

of killing almost 3,000 innocent men, women and children, should he gets the death penalty? >> he will get the death penalty if he's found guilty. >> do you agree with the fact that he will -- he should get the death penalty? >> yes, because that's what the federal law says right now. >> you've come out very strongly saying you do not support the death penalty. >> i've said i don't support it personally. i think it has its limitations. i'm not in favor of it. i wouldn't vote for it. but i understand that he's being tried now in federal court because he wasn't tried in a military tribunal as he sat in guantanamo. i said it's the attorney general's decision where to try him. as i mentioned earlier, shoe bomber, richard reid, it was tried under the republican administration and they made a decision this is where to go. it's their decision to make. if he's found guilty, and i believe he will be, and he's facing all kinds of charges, he's not going to be walking down the streets of manhattan. he will face the death penalty

and that's the law of the land even though i agree with it. >> and he was treated -- >> then why didn't they bring him in front of a tribunal?jw >> he was interrogated and getting useful information and lawyering him up at our expense and that's the next difference. >> i'm going to ask the candidates a couple of rounds of questions and then we're going to have time for closing statements. but i would like to ask each of you this time, it will be directed individually to you. and i would like to raise some concerns that have been out there on the campaign trail starting with you, mr. brown. if you could answer a couple of questions.as,ñ there are those that you've been campaigning as a moderate republican but that, in fact, you're quite conservative on some issues. i'd like to ask you a couple of questions.s+y roe v. wade, you said it is the law of the land. you respect it but you've been

endorsed by right to life groups who campaign for you.ñ would your preference be to see is that your preference? >> no. i have a long history of service as an assessor, selectman state rep, 30 years in the military. i live in a house of women that i'm very proud have to try to have people twist my record around -- >> do you support roe v. wade? >> that's never been an issue.' that's always been the case. @ltbci&> first of all, that's not an accurate quote. and secondly the climate is changing all the time. martha and i agree on it.

it's a question of what we do with regard to it. do we do it in a cap-and-trade -- >> let me quote it back. the question was do you think the whole global warming thing is a fraud. you responded it's interesting. i think the globe is always heating and cooling. you went on to say you needed more information. >> it's not accurate. >> it's what reported in the newspaper. >> i'm going to tell you what my position is right now. >> okay. >> the climate is always changing. it always has. and there's a question of whether it's manmade or natural. it's probably a combination of both but right now how do we address it. i think you're asking how do we address it and conservation, wind, solar, hydroelectric, nuclear. when was the last time we built a nuclear power plant to step back from our dependence of fossil fuel. the difference between martha coakleyybn in the midst of a recession she's in favor of a cap-and-trade scheme that's going to make energy costs skyrocket pursuant to the president. yes, the climate is changing to

answer your questions. i want to make sure we address the fact that we can step back from the uses of fossil fuels. it's pretty simple. >> ms. coakley, there are some who wondered whether you as a front runner and sometimes have been a little complacent and i wonder in looking back whether you think it was the right decision to insist on three people on the campaign given the fact when kerry said, no, i'll do it on one on one and teddy kennedy said i'll do it one-on-one. >> joe has added a lot to the debate and the discussion. and the position has always been -- i'm familiar with debates here in massachusetts is that people who are on the ballot should be able to get up when it's a public-sponsored debate and have voters judge them as they would scott or me or anyone else who gets the signatures to get on the ballot. we've had plenty of opportunities.

you can see tonight to go one-on-one on issues. there are lots of ways in which voters there get to compare us but in a public forum sponsored on television that everyone has access to, i think it makes a lot of sense. >> as you look back on the campaign, do you have any second thoughts as the campaign is unfolding? >> absolutely not. campaigns are not dress rehearsals and they move forward on their own pace and dynamic. we have campaign and i worked off. i did take christmas day off. i thought voters didn't want to hear from me on christmas day and christmas eve and somehow i'm taking this for granted or not working hard, you can look at our policy papers on the went and you can look at our volunteers and the phone-calling. i don't know what's going to happen on january 19th but i'm asking voters to vote for one of the three of us, hopefully me, and i'm working very hard day and night as my campaign to get the message out. >> you've run a tough, hard

campaign but you're in a situation now where you're coming down to the final days and you're still pretty far back. if you were not to win, do you have a preference between these two candidates as to which one you would like to see win? [laughter] >> so in all honesty i think the most important thing here -- and i will answer your question. i think the most -- the most important thing that we do here as a third-party candidate is to get the message out. none of these two candidates has been willing to talk about spending. and if they can't talk about spending, then you can't really have any intelligent discussions around the economy. and essentially i will wait -- my answer would be whoever can actually start talking about cutting of spending -- neither one of them have been willing to do so but who i would support would be the person who whenever they decide to starts being realistic about what's going on with the economy and talk about cutting spending. >> in terms of answering the question, do you have one that's closer to your model than the

other? >> i honestly think that scott at least talks about cutting taxes, which is part of the way there. my issue with scott is essentially the last year he had the opportunity when we had the referendum to cut the income tax. he's been calling for across-the-board tax cuts. we had the opportunity last year. he publicly came out against it and it was voted down. that's $3700 that could have gone out to everybody. and he voted it down. a year later, now that he's running, he's calling for the exact same thing that he didn't want to have a year ago in the same economic conditions. how do voters trust it? i don't know. >> thank you. i'd like to turn to one final question to each of you and then you'll have a chance for a closing statement. and this is about -- it's more personal in nature and that is, in traveling through the state and talking to people in the press and talking to voters there's a common refrain, that is that people sense they knew senator ted kennedy very well. as a human.

he had a chance to make a lot of personal connections and they have a lot of respect for the three of you. they all think you are nice people but they don't sense they know you very well. and they had a hard time penetrating. could you tell us -- getting beyond what you said in your advertising and your stump speeches could you give us a personal insight what you would like the voters to go into the polls thinking who you are as a person starting with ms. coakley. >> thank you. i think that's a great question, david. and part of it is we are constrained by this forum. my husband tom is here, my sister ann, my brother-in-law kevin, my nephew joe. i come from a big family. my family was the youngest of 10. i my dad owned his own insurance agency and didn't have much use for politics but i think he would be proud of the work i've done. i am driven by the work that i do, passionate for victims, kids. i do take my work very seriously

but as those who know me well i don't take myself seriously. i can be funny, believe it or not, even though most people don't think that. >> and they are laughing. >> they are laughing 'cause they know. i love to cook, downhill ski, i got two great labs. i really feel very blessed that i get to work every day on behalf of the public and have a great personal life with a tremendous husband who loves me. i think i'm very lucky. >> thank you, mr. kennedy? >> so i think it's best to state that i'm very close to my family. my father is a minister. i grew up in an adopted family. and i think the best thing people should understand is when i called my father up and told him what i was going to do here, the words out of his mouth were, oh, no, i'm very proud of you. [laughter] >> and i told him why i was doing it. and i think that people need to understand that the reason why i'm doing this -- i don't get anything out of this. this would be a pay cut for me.

the press has been, you know, less than fair in the amount of time that i get on stage is usually less than fair. this is very difficult for a third-party candidate to do but the reality is the message has to get out there. and i would risk every single thing that i do on a day-to-day basis to make sure that somebody is actually supporting the people of the state of massachusetts. because when i look at the taxes that i pay at the -- when i look at the taxes that i pay at the end of the day, i see that they have to be cut because i support a family. and everybody else here does too. >> mr. brown? >> thank you very much. and i want to thank you both for participating. i want to thank you for having this as well and being here, david. i'm hopeful that people will get to know me more than the globe and the other media outlets have portrayed me. they've done a pretty good job but there's a lot more. and it's kind of hard to talk about but this race has made me reflect -- i didn't come from a lot of money. my parents have divorced a few times.

my mom was on welfare for a period of time and i really came from nothing and i worked my way up and i have two beautiful daughters, a loving wife of 23 years. and i've been serving this state, the state that i love. i was raised here and i will probably die here and the thing that i have loved about this race is the fact that i've been able to travel all around the state and meet some great people, see some great businesses and know what their needs and hurts are. and this made me appreciate and love the state and this country even more. and i'm hopeful that people will appreciate that fact and they'll appreciate my service not only as a municipal and legislative leader but also in my military service and i'm hoping they give me a chance to go to capitol hill and try to fix what's wrong there. >> thank you. we'll now turn to closing statements. the order has been determined by lottery. first we'll go to ms. coakley. >> i'm asking for voters on january 19th to vote for me for u.s. senate. because we need to send somebody to washington who will address these difficult problems and get

results. i've done that as your attorney general. as a district attorney in middlesex county. i know the economy needs regulations. and i know that we need to get people back to work and bring jobs here. i know how to do that. and i intend to do that. and i appreciate the kinds of ideas that joe kennedy has brought to this 'cause as my friend jerry brown, attorney general in california said, we've all been spending too much money we don't have on stuff we don't need. and that is true of us individually and that is true of us as a government. that doesn't mean, however, that there aren't very important things and things that we have to spend our money on to keep our kids safe, to keep our families safe. i will do that. i property back a billion dollars as attorney general for consumers. that's my first priority. making sure we use our money smartly and that we keep our people safe. thank you. >> thank you. mr. brown? >> david, thank you for you for coming out and thank you for all of you for being such good sports and thank you to our viewers for participating. i'm so honored to be on this stage with martha and joe and

i'm honored to even be considered to be the next united states senator for this great state. there's nothing more than that i would like to do than represent you in washington. as i've done here in massachusetts. as lieutenant colonel and 30-year member of the national guard i understand the differences between the kennedys on terror. i support the president efforts to keep us safe. with regard to taxes, i've been fighting that battle on beacon hill. i looked to cut and look to hold the line on taxes that governor patrick and the political machine are pushing on us. it's happening in washington. washington is starting to act like massachusetts in that regard. taxing before saving. and i think we can do better. as the 41st senator i can go down there and at least bring conversation back. it's broken, broken here and it's broken in washington. as the 60th senator, martha, debate will be cut off. and that's not good for democracy. that's not what our founding fathers wanted and i'm hopeful i get the opportunity on january

19th and i appreciate everybody being here and i appreciate what you've done, david. thank you very much. >> mr. david kennedy. >> thank you for moderating this this evening and for everybody coming out. this election a week from now is about the small government candidate against the big government candidate. what you need scott will spend money on war, martha will spend money on healthcare. but the reality is, who do you want to spend your money? do you want the government to spend your money? or do you want to make those decisions for yourself? i'm the only candidate that will go out there and i will cut spending. i will repeal obama-care. i will file legislation to end the wars. and i will bring that money back to the people of massachusetts and the rest of the country. i will audit the federal reserve. i'm the only candidate that is willing to cut the spending. you have to ask yourself, who do you want spending your money? do you want it to be the government or do you want to make those decisions yourself?

>> thank you. ladies and gentlemen, this concludes tonight's debate. the final debate before the election next tuesday. as we leave, i'd like to thank, if we might the edward m. kennedy instituteth united states senate for sponsoring this debate. i'd like to thank the university of massachusetts at boston for hosting this event. i'd like to thank our media partners who have been covering this. eight television stations, three radio stations. the biggest gathering in memory. and for a reason because this election is so close. i'd like to urge all of you, if you have the moment, and to do this -- given what they put in to it, to go vote. everyone involved i would courage to vote. i would like to ask if you would join me in thanking the candidates who have come here tonight and who are so devoted to public service. thank you one and all. [applause]

>> afghanistan's logar province is a a mostly agricultural region located south of the capital city of kabul. freelance journalist david axe was embedded there with the u.s. army in october and november. he accompanied u.s. troops as they patrolled some of the villages in the province and worked to expand security in the area. >> prior to 2009, there wasn't much of a coalition presence in logar. there were about 100 american there. there weren't enough americans to patrol and certainly not enough to keep lofar from being a taliban stronghold. so for years the taliban used lofar as a base to launch

attacks northward toward kabul. in late 2008 and early 2009, as more americans joined the coalition, there was that first wave of reinforcements at the end of the bush administration and the beginning of the obama administration and some of those troops reinforced the small contingent in logar. so the coalition presence in logar grew from about 100 guys to about approximate 1,000 and it's still growing. so the coalition is on track to have 1500 guys in logar. this is one of the logar's districts and when the army began moving reinforcements in logar they identified as baraki block for getting a foothold in logar province.

they concentrated its area and it's the safest area. it has the best security. you see all sorts of knock-on effects as refugees return and businesses get -- new business gets started and people are getting back to work and the army does security-type patrols to maintain that level of security. but they managed to create the space they need to do development work. >> you know, we got the checkpoint down the road. >> this man by the iraqi police. i misspoke. [speaking in native tongue] >> we're looking for a village

elder representative. [speaking in native tongue] >> so we can speak on -- about of a solar powered gation that's supposed to come to this village. [speaking in native tongue] >> translator: at this time it is too late. a representative is somewhere else. that is why if you guys come like 9:00 or 10:00 in the morning or 3:00 or 2:00 in the afternoon so you guys walk up a little bit far and there is a mosque, there will be somebody in the mosque and ask him. he will show you who is the representative and he will introduce you with the representative.

>> i'm sergeant coleman, i'm with u.s. forces and we're actually looking for the village representative. [speaking in native tongue] i talked to one of your neighbors down the road, he said probably it's too late tonight. and we should come back. [speaking in native tongue] >> so while we're here we want to walk through the village and talk to some people and see everything was going, if you guys had any complaints. [speaking in native tongue]

>> travis is going to give you a number. [speaking in native tongue] >> that you can call and inform i or anything that's going on in the village in general. >> even just a couple of months ago people ran into their houses and hid, you know, that's a sign of progress, i guess. they're willing to be approached by coalition forces or american forces for that manner and actually talk to us. that's plus. small victories.

>> when you're on patrol you'll see the americans pull out this big clunky device to take these close-up photographs of afghan's eyeballs, they're rises. -- irises. it's this whole kid for -- they are taking what they call biometics and the idea is whenever you come across an afghan of interest, say, a local leader a or a male -- you know, a man of military age, certainly they come across somebody who's a taliban suspect, you know, a local bad guy, somebody that

someone else the fingered as a local trouble maker you want to create a record of this guy who he doesn't capture -- or he winds up dead, you got some sort of a paper trail establishing who this guy is, where he's been. what context you've seen him in iraq. so it goes into a various database that the coalition the afghan government maintains. and i heard there's not one central database. some of them are local databases. >> afghanistan is extremely mountainous. which is both good and bad for u.s. troops. it's good because -- well, there aren't a lot of u.s. troops in afghanistan even with recent reinforcements and even if we got more you are talking fewer 100,000 people in a country that has 15 million people, the size of texas no less.

so you can't always put an american soldier on every street corner but you want to keep an eye on those street corners so often what u.s. troops will do is pick a mountain peak and build an observation post on top of that peak, like cameras and night sensors and some weapons up there. they just sit up there and keep an eye on the area. those mountains are usually inaccessible by road. they are too steep so there's only two ways to resupply your little mountaintop outpost. preferably you wait for a helicopter but there's so many helicopters in afghanistan and everybody needs them all the time and not all the helicopters can climb to certain altitudes so they are not suited for every mission so your choices of resupplying your mountaintop mountain posts is to wait in line helicopters or to carry that stuff up by hand. or to do the afghan way and carry it up by donkey. in the baraki district decided

to try the afghan method and they were going to rent a donkey to drag this 300-pound generator up. americans don't use donkeys very often so nobody had quite the algo rhythm for how much donkey power you need for a given slope and a given weight over a given period so they rented one donkey and strapped this 300-pound generator to this donkey on a plastic sled or put it on the donkey's back to try to get the donkey to drag that generator. you need three donkeys for that rather than one so the donkey made it about 10% up the slope and quit. and so the americans well, we could leave it or we could do it ourselves and it took an hour and they hauled that generator up a mountain slope.

>> it sits in the middle of our operations in baraki district of logar province. as you can see it provides us with a good view of our east and west perimeters which borders the province and when we first came into this area about seven, eight months ago there was a lot of enemy activity along this msr route georgia and once -- so we determined we had to have an observation post. and it initially started with a -- with just that lower o.p. which is asg, the afghan

security guards to our south there. and what we call the upper -- >> an o.p. is an observation post? >> an observation post, yes. >> how far up are we? >> 7,500 feet above sea level, which -- yeah, this is probably a 1500-foot climb from the base which isn't as bad as some areas. but it's pretty steep terrain and a lot of loose gravel so you have to be cautious. with our optics that we have up here, we could monitor pretty much anything and everything from daily activities to local population to insurgent activities when they are placing explosive devices in the roads and the culverts throughout this whole area. there's a few blind spots but generally we've got this place on lockdown. and the enemy knows -- i mean, they are learning now where we can and cannot monitor their activities.

but i'll take my chances seeing 90% of their activity compared to none of it. this is o.p. spur. >> do you want to do one round and adjust and follow it. >> at the outpost at baraki barak there's a motor team and what they do -- in addition to firing mortars whenever the soldiers on patrol ask for it, say, if somebody is under attack they'll call in motars they do terrain denial which gives them a chance to practice but also the tactic they use to scare the taliban. they pick a piece of terrain that. they send the infantry terrain

guys and the infancy team pulls back and it's random so, you know, the taliban from their perspective -- they just see these periodic unpredictable massive displays of firepower and it's supposed to be -- have a deterrent effect on the taliban. >> fire! >> baraki barak is the safest district in logar but logar is still overall a fairly dangerous province by afghanistan standards. ieds are a constant threat. they provide roadside bombs and in baraki barak they tend to bury them in the middle of a dirt road as you're driving out on patrol you drive right over them. in fact, i was on patrol in october at night u.s. troops in

our -- the second truck in our convoy got blown up and no one was hurt but it did turn into a big fire-fight and some taliban were killed. [gunshots] >> ieds are the biggest threat but most of them don't actually kill anyone because the americans ride around in these big 15-ton armored vehicles with special-shaped undersides that help deflect the blasts and the bomb away from the occupants and they are called mraps. and everybody loves their mraps. they are not terribly comfortable. it's like riding around in a washing machine on the spin cycle but they will protect you from bombs.

>> i would say that in baraki barak's case, our threat of roadside bombs is a very serious threat that we take serious all the time. it is a consideration that we just -- it's always the front of our minds. it's probably the biggest concern. i would say roadside bombs being the biggest concern. >> so how do you balance the need to protect your people with the need to continually expand this security bubble and to reach out in to unsecure areas? >> well, we're going to go wherever we want, whenever we want to go there. we utilize all of our assets that we have available to us, which is every soldier just watching where we're driving, watching where we're walking. we also check our routes, remember where we go. remember where we've been and we just -- we watch ourselves as much as we watch the enemy. and we just try to stay safe everywhere wets)+q and everywhere we walk and we are  so we just keep our eyes open

and keep ourselves disciplined. >> freelance video journalist david axe was bedded in logar province in september and october. this is his second trip to afghanistan. toinatrviews of the trip visit c-span.org in the search box in the upper right-hand corner type axe.lí >> there's just two weeks left

to enter c-span's 2010 studentcam contest. $50,000 for prizes in middle and high school students. top prize $5,000 jnute video on country's greatest strengths or a challenge the country is facing. it must incorporate c-span programming and show varying points of view. . winning entries will be shown on c-span. don't wait another minute. go to studentcam.org. >> the defense and veterans affairs departments held a conference yesterday on suicide prevention. speakers include veterans affairs secretary eric shinseki. this is a little more than an hour. >> well, how exciting. boy, what an audience here. we have about 1,000 folks that have signed up for this conference so we're really excited to have you here.

this is our second handle dod va suicide prevention conference. we have been putting together quite the agenda for you. we have over 100 presenters this week up to thursday so we're real excited. some of the most well-known experts in the field of suicides so we've got quite the agenda. i'm commander janet hawkins and i'm the chair of the suicide prevention and risk committee. i'm a public health officer that's assigned with the defense centers of excellence for psychological health and traumatic brain injury under general sutton. what i'd like to do is take a few minutes to go over some administrative announcements. during all plenary and breakout sessions, please silence your cell phones and pdas and please do not turn them to vibrate as this can also be distracting in a session and interfere with the audiovisuals in the room. generally allowed for 15 minutes between session so please be mindful of the time so that we can stay on schedule.

and as you could tell we're a little behind the curve so we really want to make sure with so many folks that we stay on target. there are restrooms located on each floor of the hotel in which sessions are being held. if you have not done so already, please be sure to sign up at the registration desk. each breakout session -- you'll be evaluating individually each breakout session will be evaluated individually so please place your completed evaluations in the collection boxes outside of each room and at the registration desk. for accreditation policy ees requires 100% conference attendance to receive ceus so accredited certificates of completion will be emailed to you after you submit the final conference evaluation.?y for additional information, please review the blue sheet of paper in your folder. i'd likez!7p to introduce to m chair dr. janet kemp. [applause]

>> jan and i sincerely hope the conference will meet all your expectations and provide ideas and lessons we can learn to take back home and for the future. if you have any concerns or questions or ideas, please feel free to find either one of us. we would also like -- have you take a look at your agenda. it has the quiet room that we put on the agenda for folks that as we go through this process, we've got -- you're able to use that quiet room every day if you find that the topics are a little difficult for you. we wanted to make sure that you're able to go just for a short break if you're needing to do that. now, what i'd like to do is introduce you to the director of defense centers of excellence brigadier general sutton.(=z general sutton has been leading

this association. general sutton?ñm >> thank you so much, commander hawkins for you and the work and the spientire team in bringing s meeting together. i would like to welcome you the second annual dod va conference on suicide prevention. we have a number of leaders, very distinguished did hes who will be joining us today, some of whom are already here. i'd like to give a special welcome to ms. ellen embry, performing the duties of the acting -- of the assistant secretary of defense for health affairs, secretary shinseki, of course, from the va will be here in about a half hour. we're honored to have the chief of patient care services at the va.

we also have lieutenant general richard zellmer who's the deputy commander for man power and affairs for the marine corps and rear admiral david holloway whose the director of manpower personnel, training and education for the united states navy. we're also very pleased to welcome major general phil lopy who's the deputy commander for the joint task force capital medicine. we have also rear admiral dave smith who's the joint services sinner and we have the deputy surgeon general for the united states air force. i'm also pleased to have bonnie carol who, of course, know her as the rear of director of taps, tragedy assistance programs for survivors. and she and the general are cochairs of the dod task force on suicide prevention. so please join me in welcoming our distinguished guests. [applause]

>> i can't tell you what it is to look across this audience to know that of all of the things that are demanding our attention, at our post-camps stations and communities, that each of you would make this a priority. clearly, it speaks volunteers. -- volumes. this is not business as usual. we are here over the next few days to learn to share, to grow, to connect. as i look across this room, i see colleagues and friends from the va. i see folks from across the services, army, navy, air force, marine corps, coast guard, public health service. i see ncos, the backbone of our military. i see retirees, i see widows. i see family members who have

survived the tragedy of suicide and who are truly our best experts from whom we must learn and for whom we must continue to support. please join me in thanking the suicide family survivors who are here to teach us this week. [applause] >> you know, a wise person once said, be kinder than necessary. for everyone we meet is fighting some sort of battle. i know i am. i know you are. those battles are not limited to the war zone. they take place on the home front. they involve struggles with

injuries that are moral, physical, psychological, spiritual, seen and unseen. and they also lead to the potential for us to claim strength, no matter how adverse our experience has been. over the next few days, we have the opportunity to learn new and better ways of strengthening individuals and communities to build resilience, to maximize recovery and to foster integration at all levels. you know, preventing suicides involves much more than recognizing and acting on the terminal signs of hopelessness

and despair as important a course as that awareness and those actions are. it involves for each one of us to piled, to develop, to grow a toolkit, a toolkit for life one that involves tools for sleep. the number one issue affecting our troops coming back and forth from the battle zone. it involves the tool of fuel, got fuel. are we putting the kind of fuel into our bodies that help our brains, our bodies, our souls, our spirits to perform at maximum effectiveness and efficiency? got friends. do each of us here today have at

least two individuals that if we were to reach that hour of darkness, that moment of truth that we could call a friend? and gain that human-to-human heart to heart connection? do we belong to a team. do we fit in? those relationships are what healing is all about, what love is all about, what life is all about. got love, do we have people in our lives, pets, causes, endeavors that we put their needs ahead of our own? do we have health, health that is much more than the absence of

disease but involves the presence, the presence of energy, optimism, compassion, grace, gratitude, grit and strength. do we have faith? faith that leads us to a commitment that is greater than any of us as individuals. hope, any of us who is without hope is most at risk. growth, that potential for claiming post-traumatic growth no matter how tough the adversity. it's there for each of us. now, granted there are other domains resilience but i would -- i would have this to say. if every one of our front line

leaders -- those ncos, those young troops who are in the trenches, if they knew the answer to each of those questions about their troops, if we knew the answers about each of those questions about our family members, our leaders, ourselves and knew how to engage each other in a meaningful productive dialog, perhaps we would be a step further away from the terminal signs of hopelessness and despair. that is our challenge. this is not business as usual. for as much as we had to learn, there's much that we already know. we know, for example, that preventing suicides is first and foremost a public health challenge. think of it this way, at the center of our attention, eyes on well-being of our warriors, our veterans and, yes, our families, those who are courageous enough to love us, but it goes on from there.

we must build peer-to-peer support networks. we must build resilient families and communities, faith leaders, employers, teachers, coaches, elected officials and, yes, healthcare professionals. but let me be clear. preventing suicide is far too important and too enormous of a challenge to be left to the docs. we're all in this together. we are are our brother's keeper. we are our sister's keeper. we know that psychological, spiritual and moral injuries are on par with physical injuries. the chairman of the joint chiefs of staff, admiral mike mull geneses that quite frequently. we are blessed with the strength of visionary leadership at all levels and in both departments.

we know that these invisible wounds of war, whether depression, post-traumatic stress, anxiety, concussion, traumatic brain injury -- we know that these invisible wounds are real. we know that you are not alone. i'm not alone. we are all in this together. we know that treatment works. treatment based on an integrated team health model of care that covers the entire continuum from exposure or distress all the way through, from the battlefield to the home front to the bedside, to the kitchen table. and we also know not only does treatment work but the earlier we can intervene the better.

we know that reaching out is an act of courage and strength. as hemingway once put it, following world war i, the world breaks everyone. and many grow stronger at the broken places. finally, we must double down on our commitment to eliminate not just to minimize, not just to reduce but to eliminate stigma, that toxic, deadly hazard that all too often leads to needless suffering and loss. in summary, we are on a journey. we know that stigma can kill,

hugs can heal, words can work, treatment can save and help is hope. we are on a journey where perhaps somebody in the wisdom of churchill -- we're at that point as he put it, we're not at the beginning. this is not the end of the beginning. this is not the beginning, this is not the beginning of the end. that this is perhaps the end of the beginning. a time where we can look back and learn. we can tool up here today this week, go home and apply these lessons. and ask ourselves the question every day, is what i and my team are doing today? is this action? is our effort -- is it worthy of the service and sacrifice of who were so privileged to serve?

.. tomorrow and the day after and the day after. to this and, i am deeply honored -- tos@ has pioneered our understanding and efforts in support of health protection and readiness. someone who more recently i have had the opportunity and privilege of serving with these last couple of years in the domain of the invisible ones of war, psychological health, traumatic brain injury >> psychological health, traumatic brain injury. now, performing the duties of

the assistant secretary of defense for health affairs, ellen embrey comes to us today as much more than a distinguished leader and an esteemed colleague, although she is both of those thing thes. but to so many of us in this room around the country and throughout the world she is a role model, she is a mentor, a teacher, a coach, and a dear friend. so, please, join me in welcoming ms. be ellen embrey. [applause] >> well, good morning, everyone. i'm here on behalf of the secretary of defense, mr. gates,

unfortunately, was not available today, and so he asked me to come in and provide some opening remarks on behalf of the department. and i'm very pleased to do so. thank you, general sutton, for those very kind words and that wonderful introduction. good morning to everyone. welcome to this second annual conference on suicide prevention. it is the only conference published to specifically address the issue of suicide in the military and veterans populations. it's very important that you all are here, it's the quite obvious that you care and you spend many of your days and nights caring about this issue and making a difference in the lives of our service members and veterans and their families. i want to thank the distinguished guests who are here who were mentioned earlier, and, of course, i'd like to thank the chairman of the joint

chiefs of staff, admiral mullen, who will be here later. he has been especially dedicated to this issue and has been quite an advocate for the department in helping us all to see and address as a matter of priority the unseen wounds of war. i'd also like to thank our conference co-host and partner, secretary shinseki. when he comes, please, extend my warmest regards and thanks for his support as we jointly sponsor this conference. so let's talk a little bit about the tragedy of suicide. every life lost to suicide is both a personal tragedy and a tragedy to society. whether civilian or military. it's a tragedy because a precious human life has been lost. it is the also a tragedy because for all of our sophisticated knowledge, we still do not know all there is to know about

preventing these needless deaths from occurring. at a media round table last november, the army's vice chief of staff, peter cellly, briefed the press on his services suicide -- service's suicide prevention efforts. the challenge of suicides, he said, is without a doubt the toughest i've had to tackle in 37-plus years in the army. simply stated, he said, it is not a single problem with a defined set of symptoms or markers. there are no easy answers or solutions. and as we all know, he is right on all counts. suicide is a complex issue with any number of risk factors that is hard to predict. and while we are alarmed at the number of suicides increasing in the military, some 311 occurred in 2009, most do not occur in

the theater of operations, and most are related to the same factors that precipitate civilian suicides. substance abuse, failed marriages or relationships, and legal or financial matters. according to a 2008 department of defense report, 64% of those who died by suicides did not have a diagnosed psychiatric disorder. and 49% received medical, behavioral and family services 30 days prior to their deaths. knowing this, what is it that we can do to reduce the risk and the number of suicides in the armed forces? one key way to reduce that risk is to make sure that people understand that there are a wide variety of resources available to help them well before they become suicidal.

that means increased sensitivity to warning signs, comprehensive prevention and education and services throughout the career and the development cycles, innovative programs that target risk factors and incorporate protective strategies, increased says -- access to information and care, enhanced community and peer support, and finally and most importantly in my opinion, quality research, surveillance and analysis to close our gaps in understanding and to identify best practices for prevention. stigma is another key threat to suicide prevention. so we've taken aggressive action to educate leaders to reduce the adverse cultural impact of seeking help for psychological problems and suicidal ideology. the real warriors real battles

real strength campaign, for example, provides concrete examples of service members who have sought care for psychological health issues and yet still maintained highly successful military careers. there are several web sites and self-assessment programs that help to enable our service members and families to seek help confidentially and identify problems before they become serious. video and other education materials are in widespread use helping children and families understand and cope with the stress of multiple deployments and everyday military life. telephone hotlines, innumerable telephone hotlines, with licensed mental health consultants provide 24-hour-a-day help, and there are multiple transition programs available to help bridge the support of our service members who are between health care providers or systems. affording not just support and

encouragement, but also continued use of needed services. in short, as far as the department of defense is concerned there is no individual family member, military leader or va or dod or other community resource that could be omitted from the suicide prevention equation. becaused is is a great -- because suicide is a great concern for the department of defense, each of the military services have instituted significant efforts and programs to prevent suicide. for example, the air force has incorporated suicide prevention into their core training priorities. they've also enhanced suicide risk assessment skills of their health personnel, especially at the primary care level, and they've trained over a thousand mental health staff at 45 installations. the army with the largest challenge has conducted

standdown training for peer-level recognition of the warning signs of suicide. including intervention skills at the buddy level. they've also developed a total fitness program for soldiers, families and civilians to help them thrive in an era of high, up-tempo and persistent conflict. they've also established a robust and integrated suicide analysis system to identify trends and risk factors that enables their leaders and others to intervene at multiple levels to reduce the number of suicides. the marines have implemented a program involving a two-hour suicide prevention training session for 100% of the marines. that session includes warning signs, engagement with fellow marines and information on how to access a variety of local and national support resources. marine commanding officers also create personal prevention

messages to help reduce stigma for getting help and a suicide prevention message is incorporated into the marines 'mandatory martial arts program to demonstrate the value of resilience and the importance of seeking ways to identify and mitigate emotional stress. in addition, the marines have implemented a dedicated hotline to aid and assist those with relationship problems, the number one factor associated with suicide among marines. the navy has established an outreach group to heighten suicide awareness and education as well as implemented a comprehensive program to address psychological health needs of sailors and their families. they've conducted innumerable personal readiness summits at fleet concentration areas to provide information on a range of topics including suicide

prevention and operational stress. in addition to a train the trainer program that was blood established at locations around the globe, they've also assisted leaders in recognizing and responding to sailors in distress. now, many of these examples are, of course, not all-inclusive, but they highlight a holistic and comprehensive strategy that we are attempting to bring to bear to confront the challenge of suicide. we are doing this primarily through increasing education and awareness, building very strong systems of support, and a 360-degree level and reducing stigma to extent possible for those who are trying and need to get help. so implementing these strategies is not just a commitment, it is our obligation. it's our obligation to the men

and women who sacrifice so much to keep our country strong and free and able to do what we do on a day-to-day basis. we owe them a debt of gratitude, we owe them the very best we can give them, and we are committed to reducing the burden of suicide. the communities of partnership of both the department of defense and the department of veteran affairs are absolutely dedicated to this issue. and our attention will not flag, and our dedication will not falter. and part of that dedication and commitment is conference cans like this one. -- conferences like this one. it is designed specifically to actively engage service members and their families in suicide prevention. and to provide the resources we need and ultimately to improve those resources and the substance that drives their success. we want to reduce the number of

suicides among our veterans and in the military and, hopefully, what we learn will transcend into the national risk for suicide prevention as well. so i want to thank you all for coming. i know that this conference can is important -- conference is important. i hope that when this is over, you will be able to take away significant things that you can do back in your job to improve what we do for our soldiers, sailors, airmen, marine and coast guardsmen. thank you. [applause] >> ladies and gentlemen, please welcome back to the stage commander hawkins. >> major ed army

retired, is the senior vice president for the folds of honor foundation. he attained the rank of major in the u.s. army during his 19-year military career. on may 16, 2005, major polito was medically retired from the u.s. army from injuries sustained in combat. on the 17th of august, 2004, major polito hit an ied, otherwise known as a roadside bomb. this happened while he was serving with the coalition military assistance team under the command of general david petraeus. due to the extensive injuries to his left knee, doctors had to amputate his left leg. major polito's story of courage and sacrifice has been featured in time magazine, pga magazine, fox news, cnn, and many national and oklahoma television stations

and newspapers. since his amputation major polito has been a staunch advocate for veterans with disabilities specifically focusing on advocacy for prosthetic technologies with orr though care -- visiting with amputees and developing programs to meet the needs of veterans with mental health disabilities like ptsd. during his time at brook army medical center, major polito experienced what many tragically-wounded service members experienced in war, the inner darkness of depression. ptsd and also suicide ideation. this wound crippled his positive spirit. major polito describes this inner darkness as a deep wounding of a soldier's spirit. during this time he came to understand that as a warrior he

could not walk alone in his journey. in that moment he asked can for help from his spiritual adviser, his chaplain, his family, his therapist and the american people. this intervention helped pull his life back on the road to recovery. it also became his building block for understanding the inner wounds of war and for insuring that mental health advocates understand their responsibility to leave no one we hind on the field of bat -- behind on the field of battle. major pulido. [applause] >> thank you all very much.

when i hear that introduction, i gotta tell you that i get emotional, and one of the reasons that i get emotional is because when i got one of my blood transfusions, i think i got a little female blood in me, and now i cry all the time. [laughter] wow. just to the hear that is just incredible to me. first of all, on behalf of all of those that have served our nation, i want to take this time to thank you, those individuals that are here today and those individuals that are back home all over this great nation, to tell you thank you for the support that you've given me in my road to recovery. i know sometimes you may not hear that, but you're going to hear it from me because one of the things that's so important is that as i faced those dark days at brook army medical center on october 1, 2004, when

my leg was taken away, how sad it was that i sat in that hospital bed not knowing what was happening to me mentally, learning how to deal with the physical challenges of what was going on, and holistically knowing that i needed you as a support system in my life. i remember those three weeks at brook where i thought about the facts that as positive as i am and most people say, man, if anyone can get through, this it's major pulido. but i hit that dark place like most of our service members do, and those hidden wounds were the ones that would cripple me during a period of time that i just didn't understand. but the key moment that i want to tell you that was so inspiring to me when i sat there in that dark place was the fact that i needed you to support me

in that new journey. you see, as i sat at brook army medical center i didn't know how i was going to provide for my family, and that, to me, was the hardest thing that id struggle with -- i'd struggled with through this journey. because when they took my leg, they took so much away. but i also knew that with the help of those service members who had gone before me and those individuals who had made our country what it is today that they would get me through those dark days and dark hours and make me who i am today. and for that i thank all of you us for what you're doing. suicide for me was something i faced, and i had to talk about it, and it was that therapist george and my chaplain at brook army medical center that were

the instrumental figures in giving me my life back. so as i begin my presentation, i want to narrate my story to you and tell you that this is one of many stories. but what i want to do is just show you how important your support is in making our lives truly successful as we come back from war and we become civilians and we learn that our lives have changed, but in a way they've changed for the better. i have to begin by talking about what has made this country what it is today. you see, for me it's about winning. it's about having those service members being a part of a courageous group of people and honoring our veterans and our servicemens every time we get -- service members every time we get an opportunity to. they're the ones that provide the freedom, they are the ones that have inspired me, and they are the ones that we must truly

honor each and every day. and how great it is that our nation has been one of service, of giving back. and at times we've made mistakes, but one thing is clear: in this day and era, one thing i've learned from our vietnam vets is that we will not make those same mistakes again,, and this is a prime example of what it's all about. making sure the mistakes we've made in the past we won't make in the future, and together we can bring change in regards to how we take care of our servicemen and women. and i can tell you that this is such a grateful nation, and i live in an era where you will remember me, but you will also honor my sacrifice and help me through recovery. and the thing -- [applause] thank you.

and the thing that's so important is that as we served our nation and as we understand freedom and sacrifice, the reason i showed you those pictures was because it is so important for me that as i retired from the military to have a continued connection. because what happened to me is that at times as i laid at brook army medical center i was thinking, i'm going to be retired, i'm going to be the out of the military, and i'm going to be forgotten. and it was exactly the opposite. that's not what happened. and because of the freedoms and the sacrifices that we have endured, i began my story of what i call challenge, triumph and change. challenge is sitting on the battlefield almost losing my life, triumph is taking the first step after amputation, and change is living with the dark wounds or those mental health wounds of war and learning that

with the right support systems in place i could truly have a great life. my story starts on january 27th, 2003. after serving 14 years on active and reserve status, i got called up to, basically, train the new iraqi army. one thing that i understood was that when we go into war, we go as a joint force. and how great it is that i see my fellow brothers and sisters in the this room wearing that great uniform and knowing that as mucs i miss it, i could still do my part. and whether we had the army with us, the marines, the air force, the navy, the coast guard, all of us working in that joint environment to insure that we have the freedoms of this great nation and that we give freedom to others all across this great world. and the thing that's so

inspiring to me is as we go to war one thing is clear, our service members know how to stick together and know how to work together as a team. and in that joint environment what you find is that you may find obstacles on the battlefield that will impede, maybe, our progress for just a little bit. or those, or those pictures of war and what it looks like. and the reason that i show these to the american people is not to glorify this, but to say that these are the physical wounds that our service members come back with. these are the images that they come back with. and whether it's anxiety disorder, the depression, to hypervigilance, all of these things are clear that when you see these things on the battlefield, at times you bring 'em back home. and that was one thing that happens to all of us. whether it's the shock and awe of the mission to the track willty of what -- track willty to what it looks like in baghdad

to what we were able to provide for me specifically and those that have served our nation in this great room whether you've been in this theater of operations or not. one thing for me that was so satisfying is that we gave the iraqi people their freedom. as i embarked on this mission, i also understood that the people on the ground would also be our intel. they would also be those individuals that we would begin to develop relationships with. and at times when you saw the death and destruction of what may happen to them, those images, of course, live with you each and every day. but also knowing that what we were doing was truly a valuable mission, and whether our politicians did what they are going to do the, for us it was about winning and making sure that we accomplished a mission on the ground. and so as we stayed away from

the political climate, our job was clear. it was to provide that support so that they could control their own country and their own destiny and their own future. one thing for me that is very, very inspiring is that i understand the value of our noncommissioned officer. they're the reason that i do the work i do today for the folds of honor foundation. they are the ones that saved my life on that day. and i'm honored to tell you that because of their work i am successful because i know i have a goal and that is to take care of them and not leave them behind in the field of battle. it was my father who asked me to really think about joining the military. and when i got commissioned, the thing he said to me -- vietnam era individual, of course -- was you never leave anyone behind in the field of battle, and it's mission first, people always. and that's the way that i

understand our ncos in the military. and for us it's taking care of our own when they come back from war and making sure they're not forgotten. of course, on that august 17, 2004, day two vehicles like this in the front, two vehicles like this in the rear, four suvs in the middle, my day would change forever. i hit an ied which is called a roadside bomb or improvised explosive device. what you're going to see in the pictures, one of our vehicles coming in the picture and what it looks like to be attacked by the enemy. that's what it looks like to get hit by an ied, and on that day i faced the challenges that would change my life forever. we got ambushed. this is what it looks like. but it was so great that those

noncommissioned officers on that day took charge of the situation, secured the perimeter, got me out of that situation alive and rendered the aid to me. it was interesting, as i sat on that ground on that 128-degree pavement at about 12:04 in the afternoon, the ied shattered my left leg. i had wounds all across the left side of my body. combat medic pulls me out, puts me down. the first thing he says to me, that 24-year-old who actually i heard later who i was his first casualty was, man, major, you've hurt bad. if you've ever taken cpr, don't ever tell the patient that, by the way. [laughter] but the thing about it is that for me on that particular time the only thing i could think about was my little girl, caitlin. and when i thought about was if i die on this day, i'm never going to see her again. and all i would hope is you, the american people, would take care of her. and i know you would because

they got me out of that situation alive, put me on that helicopter 47 minutes later, and i was headed to baghdad. arrived in baghdad. seventeen hours in surgery, blood transfusions, woke up two days later, and i got awarded the purple heart by general petraeus. but let me tell you the most important thing that happened on p that day. our leader called my family and told them i would be okay. that's what it's all about. as i embarked on that mission you go from baghdad to germany, germany to the walter reed, brooke army medical center. and i would end up spending almost 40 days in icu, a total of 18 surgeries, 195-118 pounds. two staph infections and this is when i felt suicidal. and i want to show you this video because it depicts what i looked like right after this battle. >> today major ed pulido leans

on two cedar sticks. >> i need help. i had to ask for hem. >> but he'll spend the rest of his life leaning on his wife. >> this won't bring him down. i know that for a fact. >> nine weeks ago a bomb exploded beneath a vehicle he was driving through an iraqi desert. >> it's hard to talk about. >> pulido's knee was smoking, and during the next six weeks, infection ate most of his knee. if he wanted to live, he had one choice. >> i lost a leg, but that's nothing compared to the losing my life. >> so now a man who once trained iraqi soldiers in 130-degree heat can barely carry a lunch tray at a restaurant. unbearable, pulido says. i cannot things up. >> sometimes he can still feel his missing leg.

it will help. >> he said his leg was fishing. i reached down on the hospital bed and said, is that better? >> what you going to get dad? >> of ft. -- 8 ft.. >> it is a smile that could get a dad's heart to mitt -- miss a beat. >> she said, daddy, don't cry. and i tell right cannot help it. >> she said san antonio. that is w that's where caitlin and mom are driving dad so he can be fitted with a prosthetic leg. >> ice the hardest thing i've had to go through but i'm going to live through it. >> and he'll learn to walk again

with his two important crutches, his girls. >> i'm very proud of him. i'm very proud of him. he went through a very hard time. >> a time and a war that decided to keep part of pulido -- >> wearing that uniform is what i'm going to really miss. >> but a war that sent home plenty for this family. >> i wanted to show you, as h as that video, that was suicidial ideation for me. those services members who had been wounded critically and had given so much for our freedom. that really were the inspirational figures in getting me through that situation. you may have to click it. and one thing is clear that they taught me that there would be some outlets for me to gain my recovery back and one of the things i did is i went snow skiing and i actually got a

chance to play with a para olympic hockey team and the cool thing about it we lost 22-0 to them by the way. [laughter] >> but it was great to be around all these individuals that had been disabled and knowing that i was going to be retired and what was my next step in life? and so i want to do for a couple minutes is talk through what that meant to me. one thing clear i had my god with me, my family, my community. and in order to continue to give back, i linked up with major dan rooney, an f-16 fighter pilot and a pga golf professionals and to give back to those who served our nation we decided to work and embark on a foundation to provide the spouses and children of the fallen and wounded scholarships. and how great it is that we can honor their memory, educate those individuals that have

sacrificed so much for our freedom and understand that we cannot do it alone. government could not do it look. it takes a community and it takes everyone coming together to make a difference in the lives of all of those that served. and by bringing these key partners, the pga usga and all these key partners to bear, what we're doing is changing lives, working with the va, working with dod and working with so many people to get these individuals out on the golf course to do the things that they can be inspired to do. and how great it is because mental health recovery is possible because we are able to provide this access to them. my time has been cut short today but i can tell you this much, our service members have given so much. you are here to provide that support to them. and it was interesting because i must tell you that when i was at brook army medical center, it was general peter pace, former

joint chiefs who was my inspiration at a moments of time when i was so dark in that hospital room. and i'll always remember what he said to us. he said, major pulido, always remember that on that day you didn't lose your leg. on that day you sacrificed it for your country and for everyone in this nation to be free. today we are here to make sure that our service members come back. that we don't leave them behind. what will you sacrifice? will you sacrifice your time, your energy? i ask you to do that, but i also ask you to continue to make a difference in the lives of those that have given the ultimate sacrifice. the last thing i will tell you is thank you, god bless this great nation. and i salute you. thank you. [applause]

>> thank you. thank you. [applause] >> ladies and gentlemen, please welcome the chief patient care services officer from the department of veterans affairs. >> good morning. it is a deep honor and gives me great pleasure to introduce today's guest speaker. a 1965 graduate of west point, secretary shinseki completed 38 years of uniformed services in the u.s. army, including two

combat tours in the republic of vietnam and service as the army's chief of staff from 1999 to 2003. secretary shinseki became the seventh secretary of veterans affairs on january 21, 2009. ladies and gentlemen, secretary of veterans affairs, eric shinseki. [applause] >> thank you y'all very much. thank y'all very much. that's very kind and a very warm welcome. doctor, thanks for that introduction. short, it's always best. good morning, everyone. i'm honored to be here. secretary embry, it's great to see you. loree, suttons, general sutton, it's great to see you.

distinguished guests, ladies and gentlemen, let them begin by thanking secretary gates for hosting this very important conference on suicide prevention and then for having the great generosity to allow the va to partner with dod in it. we're honored to be partnered with this. i'd also like to just a take a moment and thank ellen embry for all the work she's done for all the years in strengthening the military healthcare system. ellen and i overlapped just briefly as i was finishing my time in the early days of iraq and afghanistan. it's great to see where you've taken all of this, ellen, all the very best to you and thanks for your leadership and service. i appreciate this opportunity to address your conference. throughout my years and service

in uniform, suicides were one of the most frustrating leadership challenges i faced. as i've often asked of myself and mostly of others from time to time, why do we know so much about suicides but so little about how to prevent them? why do we know so much of suicides and so little to prevent them. simple question but we continue to be challenged and for that reason i congratulate secretary embrey and general sutton as well as the folks from the va, dr. katz, and jan kemp for their wisdom of their efforts to address the serious problems related to and one time speaking as a nonclinician here -- related to the loss of self-worth and self-esteem and

how such fragility can lead to such acts of self-destruction. of the more than 30,000 suicides in this country each year, fully 20% of them are by veterans. on average 18 veterans commit suicide each day. 5 of those veterans are under our care at va. so losing 5 veterans who are in treatment every month and then not having a shot at the other 13 who for some reason haven't come under our care means that we have a lot of work to do. who's vulnerable? everyone. young and old, outgoing and reserved, male, female, officer, enlisted, me included. warriors suffer emotional wounds just as they suffer physical ones.

i'm sort of preaching to the choir here. you all know this. combat actions produce both forms of injury. where you can splint and patch physical wounds as you well know, emotional injuries don't lend themselves to such fixes. but we must continuously develop equivalent accommodations. i don't know what they are. but what are those splints and patches? to help us with the emotionally and mentally injured? we know a lot about the causes of suicide from physiological predisposition to receipt of dear john letters. in units i used to command case studying each suicide and attempted suicide by recreating the last 72 to 96 hours of a soldier's life was entirely instructive. where did he or she go, whom did they engage? what was the purpose of the engagement? what was said? what did they do?

the case study usually revealed on multiplicity of signals regarding the individual's intent. company mates, friends and other unit mates, spouses, significant others, bar keepers downtown, friends and family back home. all were gifted with a piece of the puzzle. and not until all the pieces were collected usually in aftermath was the picture complete and the signaling was usually quite clear. we know that. you know that. and the issue is how do we do better at this? this audience of healthcare providers, clinicians, counselors, researchers and community partners constitutes in military parlance -- i don't get to use it anymore but in your parlance, our main attack against suicides. you're the experts. you bring throw-weight to the discussion. you dispense help and hope to

those who see themselves as helpless and without hope. and i don't think any of us can do this alone. if we could, we'd be further along. and all of us here today may still not be enough. as those case studies always informed, there are many other witnesses to the key indicators and presuicidal behaviors. we're in this together and i consider it a fight to help the most vulnerable of our people, yours in uniform and the veterans who come to us. and as is true of most organized team activities it's usually better to be on offense than defense. the spur of the offense as i used to remember it was act, react, and counteract. and we tried never to take that first step of acting without knowing what we're going to do

in that third step when counteraction was required because that's usually the way events go, act, react, counteract. we must build and maintain a strong support system, one in which everyone has a role. where we collectively assume ownership of the problem. it's not someone else's problem. it's our problem. it doesn't matter whether there's a uniform or not. it's our problem. we own it. i think the sense of ownership is a critical aspect of the solution increasing the level of awareness throughout our communities. and in this regard, the military services probably have the edge in compelling ownership by virtue of their highly structured responsibility for reporting and accountability. and i used to recall that. and that's what those case studies were about. everyone knew who owned the issue.

it used to be that almost every suicide and many attempted suicides were case-studied to pinpoint root causes, 360-degree interviews would be conducted of reporting chain superiors and subordinates. unit buddies, unit members, family, friends in a matter of hours. the last hours of someone's life were recreated as i mentioned as best we could and reviewed. and all too often on the pieces to the question why were collected, it became clear that those warning signs were there. always there. but missed or not acknowledged for fear of interfering with someone's privacy. that was my experience. to counteract that tendency, training programs like operation saved urged participants to get involved and urged people in power to do the right thing if

they suspect someone is at risk for suicide. now, speaking for my current role at va, i think we need to do a little bit of that, that the military has learned so much from. we need to raise awareness of suicide indicators and the array of work, economic and social factors that can trigger them. not just in the patients but among our work force as well. how do we foster and sustain the goodness of the buddy system that's inherent culturally and everything military? and apply it in va amongst the population of 7.5 million that is at once diffused, expansive, highly individualized and spans an age bracket from 18 to 80 plus. i believe it can be done. maybe best? in some specific subgroups, veteran subgroups. for instance those pockets of new veterans not clustering at colleges and universities all across the country.

i was just down in florida and i got a chance to speak to some student veterans that are going through school under the gi bill, about 20 of them. by the way at usf, they play pretty good football but they have 10,000 veterans registered for school. talk about a population, right? i got to talk to about 20 of them and so we gathered in the room and while my primary interest was talking to them about the journey they were on, i said to them, you know, you're all carrying baggage. immediately i got this, you know, push-back at the table. great to see 20 years old react to a 60-year-old's comments like that. [laughter] >> yeah, you're all carrying baggage. again, that's the stiff arm, the

heisman, you're carrying baggage and i'll tell you we all do. we all did. and you came from a very structured environment where there were first sergeants and company commanders and detachment supervisory people and now you're here and you're on your own. you're going to have to figure out how to take care of each other. while we're all celebrating you you being here on the first day of school, i'm looking at graduation rates. if you don't graduate, there's no payoff for this program. so i'm entirely interested in your graduation rates. and you are carrying baggage and you're going to have to transition through this. how many of you do your best work after midnight? for some reason you come awake at 1:00 in the middle of the might and your powers of concentration is better because you've been dozing.

how many of you draw your shades in the rooms with lights on or off at night down to the windowsill every one of them. there's no gap of light? a couple more hands. how many of you have anger management problems? a couple more hands. how many of you have to read the same paragraph three times before it begins to stick? just about every hand went up. [laughter] >> welcome to the nfl. [laughter] >> you're okay. it's natural. there's a transition you're going to have to go through. it'll be helpful if you do it together. help each other. and by the way, the youngsters that's not making class, we all know what that's going to lead to. somebody figured out a way to get down the hall and we kick the bed, get them out of the sack and get them to class. graduation, that's where i'm

focused. one thing is clear. the old ways of approaching mental health and counseling and suicide prevention won't work as effectively for the youngsters of the new millennium. i keep saying that. i'm not sure what that means. but i hear it enough and so i repeat it for you and we are being attentive to that. they are different from those who came before and i can tell you that as well. most were born a decade after the last shots were fired in vietnam. they never used a dial telephone. never watched the black and white television. and if you gave them one of those old-fashioned can openers, they'd probably try weeding your garden. they've never known a world without cell phones, the internet and instant messaging. they think fast, talk fast, act fast because they grew up that way. and so we have to adjust.

engaging them requires a new and different model. no longer a desk and an imposing government building. but in coffee shops down the street or on cell phones. on the internet, or through a public service announcement they see on a flat screen tv or through a blog site. transforming our va culture to such a new less formal open format demands greater collaboration, transparency in both our services and our service delivery. i'm speaking of an environment where mental health issues in general are demystified, destigmatized, accepted and more effectively treated. where suicides are prevented because asking for help is a sign of courage. where there is meaningful outreach and ready access to high quality care, where we identify those of highest risk

and do something about it quickly. where emerging treatments and technologies coupled with new drugs advance the success of patient outcomes. that's the outcomes we're after. where veterans and active duty personnel don't feel ashamed or threatened by the idea of mental or emotional problems. and where research encompasses complementary and alternative treatments so we may determine which are the safest and most effective in relieving suffering and restoring health. how does all of that translate from theory into action? well, here at va we've taken the heart the institute of medicine's 2003 study calling suicide prevention a national imperative it drives the overall program as well as the actions we have taken so far and the ones we have taken in the future. it has had far-reaching effect for us inside va.

we've expanded our mental health work force enormously. hiring more than 4,000 new employees in the last three years. bringing our total mental health staff member enrollment to about 19,000. 400 of them are dedicated solely to suicide prevention. each of our 153 medical centers and the largest of our 774 community-based outpatient clinics now has a suicide prevention coordinator who ensures that at-risk veterans receive counseling and services as a priority. we've extended our outreach to veterans which in itself has significant life-saving potential. part of that outreach effort can be seen in our nation-wide advertising, some of you may have seen the campaign on city buses and commuter stations

raising awareness of our 24/7 suicide prevention lifeline. additionally we opened a mental health facility in new york, a nice, warm, sunny new york. [laughter] >> there we focus on developing and testing clinical and public health intervention standards for suicide prevention. at our new va research center in denver, we're studying the clinical and neuro biological risk. we launched a national suicide hotline many of you probably know about this. but for the few who may not let me just tell you we partnered on this with hhs to strengthen our seamless va/dod relationship. the opening message on the

hotline welcome back both veterans and service members to access counselors and services and the counselors on this hotline are mental health professionals. the demons of suicide don't discriminate between uniform or not uniform, neither do we. last year we further advanced our program by introducing an internet-based suicide prevention chat line for this younger generation. designed to appeal to them. we must continue to leverage opportunities to access and intervene to save lives of those in distress. you know, after all there's an established protocol at every hospital for a heart attack victim who comes through the doors. there's an established protocol from what you do from the moment that person walks through the door. why shouldn't potential suicide victims be similarly provided systemic and consistent portals for help? now, the creator for these two forward-leaning initiatives is

here, dr. jan kemp is the brain behind these two initiatives. the partnership for public service presented jan with its 2009 federal employee of the year award. for her first sign of taking its toll that is likely to come with all the stresses in a high risk, hyperstress environments that our young combat veterans have gone through. so, jan, once again, thanks to you. [applause] >> now, we all owe you a vote of thanks but the people that owe you, you know, the biggest vote of thanks are the 5,600 or so folks who called in. there are many, many, many who called in but there are 5600 of

them who are in crisis thinking about suicide and interventions occurred. and they're still with us today. they are the ones that really bear fruit and demonstrate what you've accomplished for us. now, there's no clear-cut -- i mean, i've talked about all the things that we're attempting. and there are others as well. i asked, how is va doing and my answer to you would you be, we've only just begun. there's no clear-cut answers here. and even as the issue of self-destruction becomes more complex and changing, we have to adjust. our initiatives are new. we don't have enough hard evidence yet but we think we're headed in the right direction. we can take heart at some of the early emerging trends and encourages indicators. we know, for example, that since the start of oef, oif suicide

rates have decreased in veterans who can to us for healthcare despite we lose 500 veterans we lose in our program there are many more veterans coming to us for treatment and our suicide rates for veterans, oef, oif veterans who are under our care, those rates have come down. that's a good sign. and despite public perceptions to the contrary, we don't have any evidence for increased suicide rates amongst oef and oif veterans relative to the veteran population as a whole. now, where do we go from here? well, in large measure this conference will help point the way. that's why you're here. your deliberations will provide direction for strengthening our current programs and for helping us understand what new programs may be necessary. new programs that are

innovative, forward-leaning and within the community base that we operate. the real heroes of this are the folks out there in the communities that touch our people, yours and mine every day. in conjunction with conference faculty and staff, you'll give us the benefit of your knowledge and experience confronting suicide. suicide risk and leveraging its prevention. i know, too, by sharing your insights and counsels, both dod and va stand to be better-positioned to aid the men and women who are struggling to regain the courage to live. struggling to regain the courage to live. and so i'm honored to be here. i'm privileged to share this opportunity with ellen embrey in opening today's conference. you have an important, ambitious agenda before you. thanks to all of you for participating.